IS INFLAMMATION AN AGE-RELATED CAUSE OF BPH PROGRESSION

Objective: To find the role of inflammation in BPH progression represented by prostate enlargement compared between age group. Material & method: Tissue samples of BPH were collected from biopsy, transurethral resection or open surgery. Clinical information was collected including such as patient age, prostate volume, serum prostate specific antigen (PSA) and history of retention before procedure. Patients were divided into three groups, below 63 years old (young adult), 63 - 69 years old (older adult) and equal or above 70 years old (elderly). The samples were analyzed to define the microscopic structure of the hyperplasia (stromal or glandular) and to detect prostatic intraepithelial neoplasia, atypical stromal acinic proliferation, atypical acinar hyperplasia or prostate cancer. Prostate cancer was excluded from study samples. Grade of inflammation was determined by a pathologist depending on number of inflammatory cells. Grade of inflammation was classified in two groups, with mild inflammation or moderate-to-severe inflammation. Results: A total of 1189 patients were reviewed, 1172 were diagnosed with BPH. There were 381 patients (32,5%) with age below 63 years old (young adult), 380 (32,4%) between 63-69 years old (older adult) and 411 (35,1%) in equal or above 70 years old (elderly). In young-adult group, median of prostate volume between mild and moderate to severe inflammations was 42,56 and 45,75 (p = 0,500), for older adult group median was 45,00 and 51,00 (p = 0,038), for elderly group median was 49,00 and 51,98 (p = 0,621). Conclusion: Inflammation has a role in progression of prostate enlargement especially for the older adult group. Keywords: inflammation in BPH progression, prostate volume, age, PSA

COMPARATIVE EFFICACY OF INTERMITTENT AND DAILY DOXAZOSIN THERAPY FOR LUTS ASSOCIATED WITH BPH

Objective: To investigate the efficacy of intermittent doxazosin therapy on LUTS associated BPH. Material  & Method: This study was performed between January to April 2010 enrolling 20 patients with LUTS associated BPH. Study subjects were randomly allocated to 2 therapeutic groups. The first group was assigned daily doxazosin therapy (11 patients), while the second group was assigned intermittent doxazosin therapy (9 patients). Initially all subjects were given doxazosin 2 mg daily for 2 weeks. Subsequently group I received doxazosin 2 mg daily therapy, while group II received doxazosin 2 mg every other day. All medications were taken up to 12 weeks. Outcomes were evaluated prior to therapy, and after 2, 4, 8, and 12 weeks of therapy. Efficacy of doxazosin therapy was measured by International Prostate Symptom Score (IPSS), peak urinary flow rate (Q max), and residual urine volume. Statistical analysis was performed to evaluate difference in efficacy between the treatment groups. Results: Daily doxazosin therapy for 2 weeks resulted in significant improvement of Q max and IPSS. After 4, 8, and 12 weeks significant improvement was maintained in both daily and intermittent groups, as measured by Q max, residual urine volume and IPSS. There were no significant differences in Q max, residual urine volume, and IPSS between the daily and intermittent groups at 4, 8, and 12 groups. Conclusion: There were significant improvements of Q max, residual urine and IPSS at 2 to 12 weeks in daily as well as intermittent doxazosin therapy groups. There were no significant differences in efficacy between daily and intermittent therapy group

RELATIONSHIP BETWEEN P53 EXPRESSION AND PROBABILITY OF ORGAN CONFINEMENT IN PATIENTS WITH PROSTATE CANCER IN SARDJITO HOSPITAL

Objective: To determine the association between p53 expression and the probability of organ confinement in patients with prostate cancer in Sardjito Hospital, Yogyakarta. Material & method: Prostate specimens were obtained from patients with clinical  stage  T1-T2 prostatic  adenocarcinoma  in Sardjito  Hospital between January  2007 and December 2008. Samples were processed and immunohistochemically stained in the Department of Anatomical Pathology Gadjah Mada University. Probability of organ confinement was determined by updated Partin table 2007 from preoperative serum PSA level, Gleason Score, and clinical stage. Correlation  between p53 expression and probability of organ confinement were statistically analyzed by Spearman correlation test. Results: There were 28 prostate cancer patients eligible for this study. Mean age was 65,19 ± 10,9 (28 - 81) years old. Mean preoperative PSA level were 107,13 ± 165,82 (0,20  734,20) ng/ml. Mean number of p53 expression was 97,47 ± 97,27 (5 - 396)/HPF. Significant correlation was found between p53 expression and probability of organ confinement (Spearman r = -0,441; p = 0,019). Conclusion:  p53 expression was negatively correlated with the level of organ confinement in patients with prostate cance

CONTINUOUS AMBULATORY PERITONEAL DIALYSIS USING STRAIGHT TYPE VS COILED TYPE TENCKHOFF CATHETER IN END-STAGE RENAL DISEASE PATIENTS AT SARDJITO HOSPITAL

Objective: The purpose of this study was to compare straight type versus coiled type Tenckhoff catheter for continuous ambulatory peritoneal dialysis (CAPD) in end stage renal disease. Material & method: A prospective cohort study enrolled end-stage renal disease patients undergoing CAPD for renal replacement therapy in Urology and Nephrology Department, Sardjito Hospital from January to December 2007. Identity and type of Tenckhoff catheter were recorded. Patients were grouped into two groups who used straight type catheter and coiled type catheter for CAPD, then observed for post-operative complication. Statistical analysis was done using SPSS 14.0 with chi-square test. Results: There were 27 patients included in this study. The cause of end-stage renal disease was mostly DM and hypertension. The most common complication after  operation  was catheter  obstruction  (9 patients). Another complication was intraabdominal bleeding (1 patient), and catheter migration (1 patient). In patients with straight catheter (20 patients), there were 8 patients (40%) with complication. In patients with coiled catheter (7 patients), there were 3 patients (42%) with complication. There was no significant difference in complications between straight and coiled catheter groups (p = 0,895). Conclusion: The result of this study revealed that no significant difference in complication between straight and coiled catheter for CAPD in end-stage renal disease patient